Brian P. Dunphy

Brian P. Dunphy

Mintz Levin

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The Supreme Court Adopts Broad Scope of False Claims Act Liability

A unanimous Supreme Court issued its long-awaited and closely watched decision today on the scope of the False Claims Act (“FCA”), and the Court affirmed the FCA’s long reach. Universal Health Services, Inc. v. United States...more

6/17/2016 - Conditions of Payment False Claims Act (FCA) False Implied Certification Theory Federal Contractors Fraud Implied Certification Material Misrepresentation Materiality Medicaid Medicare Mental Health SCOTUS Universal Health Services Inc v United States ex rel Escobar Unlicensed Medical Providers

Already Enormous False Claims Act Penalties Set to Increase

The already enormous per-claim penalties under the federal False Claims Act (“FCA”) may nearly double by August 1, 2016, ratcheting up the stakes of FCA cases for health care providers, pharmaceutical and medical device...more

5/9/2016 - DOJ False Claims Act (FCA) Health Care Providers Legislative Committees Medicaid Statutory Penalties

CMS Delays 60-Day Rule, But Overpayment Case Law Emerging

The Centers for Medicare & Medicaid Services (CMS) recently announced a one-year delay in finalizing the long-awaited and closely watched rule addressing the 60-day deadline to return Medicare and Medicaid overpayments (the...more

2/24/2015 - Affordable Care Act Civil Monetary Penalty CMS DHS DOJ Financial Conduct Authority (FCA) Medicaid Medicare Overpayment Physician Medicare Reimbursements Qui Tam Relators Social Security Act

The Seventh Circuit Rejects Medicaid False Claims Act Suit

The United States Court of Appeals for the Seventh Circuit affirmed the dismissal of a False Claims Act (“FCA”) case against Shopko Operating Stores, LLC, in which a former Shopko pharmacist asserted Medicaid billing...more

11/19/2014 - Appeals False Claims Act (FCA) Medicaid Pharmacies Prescription Drugs Qui Tam

PRIME Act: New Legislation to Curb Health Care Fraud

The United States Senate and House of Representatives recently introduced bipartisan legislation designed to reduce fraud, waste, and abuse in the Medicare and Medicaid programs. The legislation, entitled “Preventing and...more

6/17/2013 - CMS Fraud HHS Information Sharing Medicaid Medicare Overpayment Proposed Legislation Recovery Audit Contractors (RACs) Waste

CMS Publishes Final Sunshine Act Rule; Data Collection to Begin on August 1, 2013

The long-awaited final rule (the Final Rule) implementing the Physician Payments Sunshine Act (Sunshine Act) has arrived at the Federal Register. It amends key definitions and adds new terms; retains broad reporting...more

2/5/2013 - CMS Compliance Continuing Medical Education Data Collection Enforcement GPOs Medicaid Medical Devices Medical Supplies Payment Records Pharmaceutical Industry Physicians Reporting Requirements Sunshine Act

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